Acute pyelonephritis
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Jul 10, 2021 · Acute pyelonephritis is a bacterial infection causing inflammation of the kidneys and is one of the most common diseases of the kidney. Pyelonephritis occurs as a complication of an ascending urinary tract infection (UTI) which spreads from the bladder to the kidneys and their collecting systems. Symptoms usually include fever, flank pain, nausea, vomiting, burning …
Question 14 4 out of 4 points Patient is admitted for acute bilateral pyelonephritis. What is the appropriate ICD-10-CM code? Selected Answer: b. N10 Correct Answer: b. N10 Response …
Acute pyelonephritis. N10 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM N10 became effective …
Question 12 4 out of 4 points Patient is admitted for acute bilateral pyelonephritis. What is the appropriate ICD-10-CM code? Selected Answer: c. N10 Correct Answer: c. N10 Response …
All patients with suspected acute pyelonephritis should have a urine culture and antimicrobial susceptibility testing to guide possible adjustment of the initial antimicrobial regimen (if there is no improvement) and selection of step-down oral therapy for patients treated initially with intravenous therapy. 15
By definition, acute pyelonephritis is an infection of the renal pelvis and kidney that usually results from ascent of a bacterial pathogen up the ureters from the bladder to the kidneys. It is estimated that acute pyelonephritis accounts for approximately 250,000 office visits and 200,000 hospital admissions each year in the United States, and approximately 11 hospitalizations per 10,000 Canadian women each year. 1 – 3 The incidence of acute pyelonephritis is highest in otherwise healthy women 15 to 29 years of age, followed by infants and older persons. 4 Although acute pyelonephritis also occurs in men, children, and pregnant women, these groups account for only a small percentage of cases. Accordingly, this review focuses on diagnosis and treatment of acute pyelonephritis in nonpregnant women.
Initial treatment of women with acute pyelonephritis who require hospitalization should include an intravenous antimicrobial regimen, such as a fluoroquinolone, an aminoglycoside (with or without ampicillin), an extended-spectrum cephalosporin or penicillin (with or without an aminoglycoside), or a carbapenem.*.
Treatment options for women with acute pyelonephritis not requiring hospitalization include 500 mg of oral ciprofloxacin (Cipro) twice per day for seven days; 1,000 mg of extended-release ciprofloxacin once per day for seven days; or 750 mg of levofloxacin (Levaquin) once per day for five days.
In 2010, the Infectious Diseases Society of America updated its 1999 guidelines on the treatment of acute uncomplicated cystitis and pyelonephritis in women. 15 The guidelines include recommendations for antimicrobial regimens in patients with acute pyelonephritis.
Therapy with appropriate empiric antibiotics should produce improvement within 48 to 72 hours. If the patient does not improve as expected (i.e., no progressive reduction in, or resolution of, the local and systemic signs and symptoms that led to the diagnosis), strong consideration should be given to a complication of acute pyelonephritis or an alternative diagnosis, and appropriate additional testing should be performed.
Escherichia coli is the most common pathogen in acute pyelonephritis, and in the past decade, there has been an increasing rate of E. coli resistance to extended-spectrum beta-lactam antibiotics.